Laparoscopic transabdominal preperitoneal hernia repair versus modified-Kugel hernioplasty via hernia ring approach

Abstract

Objective To compare the clinical effects of laparoscopic transabdominal preperitoneal hernia repair(TAPP) and modified-Kugel hernioplasty via hernia ring approach (Modified-Kugel hernioplasty). Methods The clinical data of 202 patients with inguinal hernia treated at our hospital from January, 2015 to December, 2016 were retrospectively analyzed. Of the 202 patients, 85 underwent TAPP (a TAPP group), and 117 Modified-Kugel hernioplasty (a Modified-Kugel group). The intra- and post-operative situations as well as the occurrence of complications were compared between the two groups. Results The intraoperative bleeding volume, VAS score 24 h after operation, time for off-bed activity, and hospital stay after surgery were better in the TAPP group than in the Modified-Kugel group [(14.84±6.95) ml vs. (18.46±8.45) ml, (2.27±0.97) vs. (2.56±1.03), (10.05±2.54) h vs. (20.74±4.39) h, and (3.92±1.18) d vs. (5.14±1.42) d], with statistical differences (all P 0.05). However, the incidence of seroma was higher in the TAPP group than in the Modified-Kugel group [12.94%(11/85) vs. 3.42% (4/117), P<0.05]. All the patients were followed up 1 year, and no recurrence happened. Conclusions Both operations for inguinal hernia are safe and effective. TAPP has the advantages of less postoperative pain and faster recovery, but high hospitalization cost. The surgeon can choose the optimum treatment on the basis of intention and economic conditions of patients, as well as experience of surgeons. Key words: Inguinal hernia; Laparoscopy; Preperitoneal space; Hernioplasty